Pharmacy Compliance Quality Control Auditor

The Quality Control (QC) Auditor is responsible for performing detailed audits of KnippeRx pharmacy and contact center operations to verify compliance with internal Standard Operating Procedures (SOPs), accreditation standards (NABP, ACHC), and regulatory requirements.

This position supports the Compliance and Quality teams by conducting transaction-level reviews, validating CAPA effectiveness, and identifying process improvement opportunities to prevent recurrence of errors or compliance gaps.  The QC Auditor reports to the Compliance Manager and works collaboratively with Operations, Quality, and Client Services teams to maintain a culture of continuous compliance and patient safety.

Quality Control Auditing

• Perform daily, weekly, and targeted audits of pharmacy dispensing, order verification, data entry, and patient support transactions to confirm compliance with SOPs, regulatory requirements, third party payer contracts, and program-specific client rules.
• Audit for accuracy in prescription processing, patient communication documentation, and billing or reimbursement workflows.
• Conduct retrospective file reviews to ensure completeness, accuracy, and compliance with HIPAA, DEA, and accreditation standards.
• Document findings in a standardized audit log, and provide clear, evidence-based feedback to responsible departments.
• Assist in developing and refining audit checklists and scoring methodologies to align with evolving compliance and operational needs.
• Participate in readiness reviews for NABP, ACHC, board of pharmacy, and client audits to verify document accuracy and adherence to quality standards.

CAPA Verification and Continuous Improvement

• Support the Compliance Manager and Quality team in monitoring CAPA completion and verifying the effectiveness of corrective actions.
• Conduct post-CAPA follow-up audits to validate that corrective and preventive measures are fully implemented and sustained.
• Track recurring trends and escalate repeat deficiencies to leadership with risk-based prioritization.
• Partner with process owners to provide feedback on procedural gaps, training needs, or system improvements.
• Contribute to CAPA documentation by providing audit data and evidence supporting resolution or ongoing monitoring.

Documentation and Reporting

• Maintain organized and auditable records of all quality control reviews, including findings, recommendations, and follow-up actions.
• Prepare weekly and monthly audit summary reports for review by the Compliance Manager and Compliance Committee.
• Support external and client audits by providing requested documentation and demonstrating internal control processes.
• Assist in developing dashboards or scorecards summarizing audit performance, compliance trends, and error reduction metrics.

Compliance and Accreditation Support

• Support KnippeRx accreditation readiness by ensuring compliance with NABP, ACHC, and state board requirements.
• Conduct internal spot checks for accreditation-related process controls such as patient communication documentation, pharmacist review, and complaint resolution tracking.
• Verify that staff training and licensure requirements are up to date as part of accreditation compliance monitoring.
• Participate in internal mock audits and provide recommendations for continuous improvement.

Training and Process Improvement

• Assist in developing training materials and conducting refresher sessions based on recurring audit findings.
• Provide real-time coaching feedback to technicians or agents when process deviations are identified.
• Support process improvement projects by contributing audit-based insights to improve workflow efficiency and reduce risk.

The above duties are meant to be representative of the position and not all-inclusive.

MINIMUM JOB REQUIREMENTS:

• High School diploma or equivalent, Bachelor Degree strongly preferred
• One (1) year of previous pharmacy technician experience with exposure to all functional areas (Prescription data entry, medical records, etc.)
• Pharmacy Technician Certification (CPhT) preferred; active or eligible for registration in at least one state.
• Minimum 3–5 years of experience in specialty pharmacy, mail-order pharmacy, or quality/compliance auditing environment.
• Knowledge of NABP, ACHC, HIPAA, and DEA regulations related to pharmacy operations.

KNOWLEDGE, SKILLS & ABILITIES:

• Strong attention to detail and analytical skills with ability to identify root causes and recommend solutions.
• Proficient with Microsoft Excel, SharePoint, and compliance tracking systems (e.g., Trackwise,ZenQMS, MasterControl, or equivalent).
• Excellent written communication and documentation skills.
• Ability to work independently and manage multiple audit priorities in a fast-paced environment.
• Advanced knowledge of medical terminology (including sig codes and Roman numerals), brand and generic names of medications, and general pharmacy terminology
• Accuracy: Maintains high standards of precision in reviewing operational transactions.
• Accountability: Owns findings and follows through to ensure CAPA completion.
• Compliance Mindset: Understands and reinforces regulatory and accreditation standards.
• Critical Thinking: Identifies patterns and proposes actionable solutions.
• Collaboration: Works effectively with cross-functional teams to resolve audit findings.
• Excellent organization skills and detail oriented
• Ability to accept ambiguity at times and apply decision making skills to determine course of action
• Ability to follow established process flows
• Ability to perform accurately and efficiently
• Basic math skills
• Strong understanding and practice of data entry, medical records, and dispensing systems and equipment
• Ability to possess and obtain knowledge of medication names – generic and trade
• Ability to recognize subtle differences in names and numbers
• Ability to work effectively in highly stressful situations, exhibiting flexibility in changing situations
• Recognizes the importance of patient safety

PHYSICAL DEMANDS:

• Location of job activities 100% inside
• Extensive manual dexterity (keyboarding, mouse, phone)
• Use of phone for communication
• Sit for prolonged periods of time
• Ability to travel out of state 25%

Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.